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In the various roles he has undertaken through the years, Val J. Halamandaris has been a singular driving force behind the policy and program initiatives resulting in the recognition of home health care as a viable alternative to institutionalization. His dedication to consumer advocacy, which enhances the quality of life and dignity of those receiving home health care, merits VNA HealthCare Group’s highest recognition and deepest respect. 

VNA HealthCare Group

I have the highest respect for them, especially for the nurses, aides and therapists, who devote their lives to caring for people with disabilities, the infirm and dying Americans.  There are few more noble professions.

President Barack Obama

Home health care agencies do such a wonderful job in this country helping people to be able to remain at home and allowing them to receive services

U.S. Senator Debbie Stabenow (D-MI) Chair, Democratic Steering and Outreach Committee

Home care is a combination of compassion and efficiency.  It is less expensive than institutional care...but at the same time it is a more caring, human, intimate experience, and therefore it has a greater human’s a big mistake not to try to maximize it and find ways to give people the home care option over either nursing homes, hospitals or other institutions

Former Speaker of the U.S. House of Representatives Newt Gingrich (R-GA)

Medicaid covers long-term care, but only for low-income families.  And Medicare only pays for care that is connected to a hospital discharge....our health care system must cover these vital services...[and] we should promote home-based care, which most people prefer, instead of the institutional care that we emphasize now.

Former U.S. Senator Majority Leader Tom Daschle (D-CD)

We need incentives to...keep people in home health care settings...It’s dramatically less expensive than long term care.

U.S. Senator John McCain (R-AZ)


Home care is clearly the wave of the future. It’s clearly where patients want to be cared for. I come from an ethnic family and when a member of our family is severely ill, we would never consider taking them to get institutional care. That’s true of many families for both cultural and financial reasons. If patients have a choice of where they want to be cared for, where it’s done the right way, they choose home.

Donna Shalala, former Secretary of Health and Human Services

A couple of years ago, I spent a little bit of time with the National Association for Home Care & Hospice and its president, Val J. Halamandaris, and I was just blown away. What impressed me so much was that they talked about what they do as opposed to just the strategies of how to deal with Washington or Sacramento or Albany or whatever the case may be. Val is a fanatic about care, and it comes through in every way known to mankind. It comes through in the speakers he invites to their events; it comes through in all the stuff he shares.

Tom Peters, author of In Search of Excellence

Val’s home care organization brings thousands of caregivers together into a dynamic organization that provides them with valuable resources and tools to be even better in their important work. He helps them build self-esteem, which leads to self-motivation.

Mike Vance, former Dean of Disney and author of Think Out of the Box

Val is one of the greatest advocates for seniors in America. He goes beyond the call of duty every time.

Arthur S. Flemming, former Secretary of Health, Education, and Welfare

Val has brought the problems, the challenges, and the opportunities out in the open for everyone to look at. He is a visionary pointing the direction for us. 

Margaret (Peg) Cushman, Professor of Nursing and former President of the Visiting Nurses Association

Although Val has chosen to stay in the background, he deserves much of the credit for what was accomplished both at the U.S. Senate Special Committee on Aging, where he was closely associated with me and at the House Select Committee on Aging, where he was Congressman Claude Pepper’s senior counsel and closest advisor. He put together more hearings on the subject of aging, wrote more reports, drafted more bills, and had more influence on the direction of events than anyone before him or since.

Frank E. Moss, former U.S. Senator

Val’s most important contribution is pulling together all elements of home health care and being able to organize and energize the people involved in the industry.

Frank E. Moss, former U.S. Senator

Anyone working on health care issues in Congress knows the name Val J. Halamandaris.

Kathleen Gardner Cravedi, former Staff Director of the House Select Committee on Aging

Without your untiring support and active participation, the voices of people advocating meaningful and compassionate health care reform may not have been heard by national leaders.

Michael Sullivan, Former Executive Director, Indiana Association for Home Care

All of us have been members of many organizations and NAHC is simply the best there is. NAHC aspires to excellence in every respect; its staff has been repeatedly honored as the best in Washington; the organization lives by the highest values and has demonstrated a passionate interest in the well-being of patients and providers.

Elaine Stephens, Director of Home Care of Steward Home Care/Steward Health Systems and former NAHC C

Home care increasingly is one of the basic building blocks in the developing system of long-term care.  On both economic and recuperative bases, home health care will continue to grow as an essential service for individuals, for families and for the community as a whole.

Former U.S. Senator Olympia Snowe (R-ME)

NCOA is excited to be part of this great event and honored to have such influential award winners in the field of aging.

National Council of Aging

Health care at home…is something we need more of, not less of.  Let us make a commitment to preventive and long-term care.  Let us encourage home care as an alternative to nursing homes and give folks a little help to have their parents there.

Former President Bill Clinton

Congress Faces Renewed Push to Improve PACE

May 20, 2014 01:01 PM


The Program of All-Inclusive Care for the Elderly (PACE) is a joint Medicare and Medicaid program that coordinates the care of seniors with chronic conditions, so that they can live in the community as much as possible. PACE integrates acute, preventative, primary, and long-term services and supports through an adult day care center.

The National Council on Medicaid Home Care – a NAHC affiliate – reports on recent developments withing the PACE program:

Recent Developments

On May 2, Congressmen Earl Blumenauer (OR-03) and Chris Smith (NJ-04) introduced the PACE Pilot Act (HR 4543), which called for the streamlining of the PACE program. The bill called for budget neutral reform, “increased operational flexibility” and a reduction in “technical and administrative barriers.” For the full bill, click here

The PACE Pilot Act follows calls in March both from the President’s budget proposal for the Department of Health and Human Services (HHS) for Fiscal Year 2015, as well as from the Medicare-Medicaid Coordination Office of the Centers for Medicare & Medicaid Services’ (CMS) Fiscal Year 2013 Report to Congress to expand the PACE program to individuals between ages 21 and 55. 

While the Bill did not explicitly call for an expansion of PACE to those individuals, Congressman Blumenauer stated that “there is a group of people out there who currently don’t qualify for PACE because of the age requirement. This bill allows us to see how we can bring them into the fold efficiently and affordably.” To see Blumenauer’s full quote, click here.

The past couple of months have seen major developments in PACE. In late March, Virginia Democratic Gov. Terry McAuliffe signedH.B. 702, giving all that request a PACE screening the right to such a screening, regardless of their eligibility for medical assistance under the state plan. To see a press release on the law, click here.  In early April, Kansas announced that it would expand its PACE programs from eight to 59 counties.

Characteristics of PACE

Eligibility. To be eligible for PACE, a person must be 1) aged 55 or older; 2) need nursing home care as certified by their state; 3) be able to safely live in the community and 4) reside in a PACE service area.

Demographics. According to the National PACE Association, while beneficiaries have to need nursing home care to qualify for PACE, over 90 percent of PACE beneficiaries live in the home and community, versus only 7 percent living in a nursing home.  Almost half (49 percent) of PACE enrollees are diagnosed with dementia. 

Services provided. PACE provides many services, including: adult day care, home health, and therapies (occupational, physical, and recreational), medical care, personal care, prescription drugs, social services, and respite care.  For a full list of services, click here.

Payment. Medicare enrollees have Medicare paying for all Medicare covered services.  Medicaid enrollees either have no cost-sharing responsibility, or pay a small monthly payment for the long-term services and supports component of PACE. Payment is awarded to providers via a “capitated funding arrangement,” according to the National PACE Association.


PACE began in 1971, when three people executed articles of incorporation for the San Francisco-based Chinatown-North Beach Health Care Planning and Development Corporation, which was later named On Lok Senior Health Services.  On Lok is a non-profit that integrates community-based care. In 1974, On Lok began receiving Medicaid reimbursement for adult day health services, and the following year provided housing assistance, in-home care, and home-delivered meals.

In 1990, the Centers for Medicare & Medicaid Services issued waivers to the first PACE centers.  By 1994, the National PACE Association (NPA) was formed, and 11 PACE centers were operating in nine states.  By 1997, PACE was recognized as a permanent provider type under both Medicare and Medicaid. 

PACE centers continued to proliferate.  In March 2014, the number of open PACE centers passed 100. As of this writing, 104 PACE centers provide care to approximately 56,000 beneficiaries in 31 states.  For a complete history, click here.


The National Council on Medicaid Home Care supports PACE as a key program that provides home and community-based services to seniors with chronic care. The Council supports PACE’s expansion not only throughout the states in its current form, but to those between the ages of 21 and 55 as well, so long as these expansions do not compromise other state rebalancing initiatives such as Balancing Incentive Payment Program and Money Follows the Person. Home care agencies are encouraged to keep abreast of PACE developments in their states, and to contact the Council with any questions or concerns.




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